Q: I went back to work full-time when my baby was 7 weeks old. I express my milk with an electric pump at work twice a day and feed my baby on my lunch hour. Lately however, my milk volume is less. I used to easily get 5-6 ounces each time but now am lucky to get 3-4 ounces. What gives? Nothing in our routine has really changed that I can see. I am worried that my baby isn’t getting enough expressed breast milk at each feeding since I normally just pump for missed feedings. Should I “stock up” and pump at home over the weekend? Should I have the sitter give the baby water if he still seems thirsty? Should I try and increase volume somehow?
A: I understand your concern about running low on expressed milk. Sometimes in the course of a busy day, we don’t realize that we are not drinking enough fluid and it can affect your milk supply briefly. Sometimes the stress of a day can influence your milk supply for a pumping or two as well.
If you are short only one or two ounces, ask the sitter to “pace” a feeding. That is, offer one or two ounces at a time, with an interval of an hour or two between the feedings. Since milk comes out of a bottle so much more rapidly than from the breast, sometimes babies guzzle it down and act like they are still hungry. (The brain needs at least 20 minutes to know that the stomach has received food for the “satiety signal” to kick in.) This technique can tide baby over until mom arrives and she can nurse directly from the breast.
It is also possible to pump at different times over the weekend, during long naps or late at night after baby is asleep to have some milk in the event of situations like this. Since the breast is never really empty, this will not take any milk away from the baby, should they wake up and need to be fed.
I also recommend feeding baby directly from the breast when dropping off at the sitter’s or before leaving the house in the morning. This “tops off” baby’s tummy so there is a longer interval until a bottle feeding is needed.
To increase your milk supply by pumping, always try to pump for at least two minutes after you see the last drops of milk. This increases the prolactin levels in your blood stream which influence milk supply. Try not to have intervals of more than three or four hours between pumpings, if possible, to keep prolactin levels stimulated.
—Mary Kay Smith
IBCLC, Lactation Consultant